Super elastic loop extraluminal materials delivery instrument

ABSTRACT

A materials delivery instrument is provided and includes an outer sheath and an instrument movably mounted within the outer sheath. The instrument includes a treatment lumen extending substantially the length of the instrument for receipt of treatment material. A super elastic wire is positioned in at least a distal end of the instrument. The super elastic wire forms a loop in an unstressed state to allow the instrument to encircle an anastomosis formed between a pair of tubular tissue sections. The super elastic wire is in a stressed state when the instrument is retracted within the outer sheath and in the unstressed state when the instrument is extended from the outer sheath to enclose the anastomosis. A proximal end of the super elastic wire is oriented substantially perpendicular to a plane formed by the loop to allow the instrument to lie parallel to the tubular tissue sections during the spraying of the anastomosis. A source of air pressure may be provided through the instrument to facilitate spraying the treatment material onto the anastomosis.

BACKGROUND

1. Technical Field

The present disclosure relates to a materials delivery instrument. Moreparticularly, the present disclosure relates to a materials deliveryinstrument having a preformed loop of super elastic material forextraluminal delivery of treatment material to the circumference of ananastomotic site.

2. Background of Related Art

Various surgical procedures involve removal of a diseased section oftissue from a tubular tissue or organ and reconnecting the ends of theremaining healthy tubular tissue sections. This is termed forming ananastomosis between the tubular tissue sections. The methods of formingan anastomosis may be loosely grouped into two general categories. Inthe first category, the fasteners used to rejoin the healthy tubulartissue sections are applied within the lumen defined by the tissuesections while in the second category the fasteners are applied to theexterior of the tissue sections.

In the first category, such as, for example, in colon or bowel surgery,a diseased section of the tissue is excised and the remaining healthysections of tissue are rejoined. This is typically accomplished bypositioning an anvil within one tubular tissue section and a staple headwithin the opposite tubular tissue section. The free ends of the healthytissue sections are secured or “purse stringed” radially inwardlyadjacent a shaft connecting the anvil to the staple head. The anvil andstaple head are then approximated to draw the healthy tubular tissuesections adjacent one another. Thereafter, staples are ejected from thestaple head through the inwardly directed edges of the tissues and intothe anvil to secure the tissue sections together. Excess tissueextending into the lumens of the tubular tissue sections is cutaway tocomplete the formation of the anastomosis.

Alternatively, in the second category, when relatively small tubulartissue sections, such as, for example, vascular tissue sections, arebeing operated upon, the cut free ends of the vascular tissue sectionsare everted or flared radially outwardly. The radially extending freeends of the tissues are then either stapled or sutured together to formthe anastomosis.

When forming an anastomosis in either of the first or second categories,leakage of bodily fluids through gaps in the anastomosis can occur.Further, necrosis or death of substantial amounts of stapled or suturedtissue may occur before the healthy tissues have a chance to healtogether resulting in an incomplete anastomosis.

Therefore, a need exists for a materials delivery system capable ofapplying a sealant or an adhesive to the external circumference of theanastomosis to hold the tissues together during healing. Additionally, aneed exists for a delivery system capable of applying a variety ofmedicaments to the circumference of the anastomosis to facilitate andpromote healing.

SUMMARY

There is disclosed a materials delivery instrument including an elongatetube having a treatment lumen. The treatment lumen extends from aproximal end of the instrument and terminates short of the distal end ofthe instrument. At least one port extends between the treatment lumenand an exterior of the distal end of the instrument. A super elasticwire is positioned within a distal end of the instrument. The superelastic wire has a straight configuration in a stressed condition and aloop configuration in the unstressed condition such that the distal endof the instrument assumes the shape of the super elastic wire forencircling a tubular tissue section.

An outer sheath is movably positioned over the instrument such that thesuper elastic wire is in the stressed condition when retracted into thesheath and in the unstressed condition when the instrument is extendedbeyond a distal end of the sheath.

A source of treatment material is provided at a proximal end of thetreatment lumen for delivery to the at least one port. In oneembodiment, the treatment material is an adhesive. In a specificembodiment, the adhesive is a fibrin glue. In another embodiment, thetreatment material is a sealant. In an alternative embodiment, thetreatment material is a medicament.

In one embodiment, the super elastic wire is embedded in the distal endof the instrument. In an alternative embodiment, the instrument includesa shaping lumen located within the distal end of the instrument and thesuper elastic wire is positioned within the shaping lumen.

In another embodiment, the super elastic wire has a proximal portionoriented perpendicular to a plane defined by the loop when the superelastic wire is in the unstressed condition.

There is also disclosed a materials delivery instrument including anelongate tube having a treatment lumen for receipt of treatment materialtherethrough. The treatment lumen extends from a proximal end of theinstrument to a distal end of the instrument. An auxiliary lumen isprovided for receipt of air pressure and extends from a proximal end ofthe instrument to the distal end of the instrument. A super elastic wireis positioned within a distal end of the instrument. The super elasticwire has a straight configuration in a stressed condition and aloop-shaped configuration in the unstressed condition such that thedistal end of the instrument assumes the shape of the super elastic wirefor encircling a tubular tissue section.

An outer sheath is movably positioned over the instrument such that thesuper elastic wire is in the stressed condition when retracted into thesheath and in the unstressed condition when the instrument is extendedbeyond a distal end of the sheath.

In one embodiment, a deflector is positioned adjacent the distal end ofthe auxiliary lumen for directing airflow towards treatment materialejected from a distal end of the treatment lumen.

In one embodiment, a shaping lumen is formed within the distal end ofthe instrument such that the super elastic wire is positioned within theshaping lumen.

In a specific embodiment, the super elastic wire has a proximal portionoriented substantially perpendicular to a plane defined by the loop whenthe super elastic wire is in the unstressed condition.

There is also disclosed a method of delivering treatment material to ananastomosis formed between a pair of tubular tissue sections. The methodincludes providing a materials delivery instrument including an elongatetube having a treatment lumen, the treatment lumen extending from aproximal end of the instrument and toward a distal end of theinstrument; at least one port extending between the treatment lumen andan exterior of the distal end of the instrument; a super elastic wirepositioned within a distal end of the instrument, the super elastic wirehaving a straight configuration in a stressed condition and aloop-shaped configuration in an unstressed condition such that thedistal end of the instrument assumes the shape of the super elastic wirefor encircling a tubular tissue section; and an outer sheath movablypositioned over the instrument such that the super elastic wire is inthe stressed condition when the instrument is retracted into the sheathand in the unstressed condition when the instrument is extended beyond adistal end of the sheath.

The method includes the steps of positioning a distal end of thematerials delivery instrument adjacent an anastomosis formed between apair of tubular tissue sections and extending the instrument beyond thedistal end of the sheath to release the super elastic wire from thestressed condition to the unstressed condition such that the instrumentencircles the anastomosis. Thereafter, treatment material is sprayed outof the at least one port and onto the outer surface of the anastomosis.

In one embodiment, the at least one port extends through a side wall inthe instrument and the treatment material is sprayed through the atleast one port and onto the entire outer circumference of theanastomosis simultaneously.

In an alternative embodiment, the treatment material is progressivelysprayed onto the anastomosis as the instrument is extended from thesheath and around the anastomosis.

In a further alternative embodiment, the treatment material is sprayedonto the anastomosis as the instrument is retracted back into thesheath.

In a still further alternative embodiment, the distal end of thematerials delivery instrument is positioned substantially perpendicularto the tubular tissue sections and reoriented substantially parallel tothe tubular tissue sections prior to spraying the treatment materialonto the anastomosis.

DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed materials deliveryinstrument are disclosed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of one embodiment of a materials deliveryinstrument;

FIG. 2 is a perspective view, with parts removed, of the materialsdelivery instrument of FIG. 1 with a portion of the materials deliveryinstrument extended out of a sheath of the materials deliveryinstrument;

FIG. 3 is a perspective view of the distal end of the materials deliveryinstrument positioned adjacent an anastomosis formed between a pair oftubular tissue sections;

FIG. 4 is a perspective view of the instrument initially encircling theanastomosis between the tubular tissue sections;

FIG. 5 is a perspective view of the instrument completely encircling theanastomosis between the tubular tissue sections and spraying treatmentmaterial onto the anastomosis;

FIG. 6 is a cross-sectional view taken along line 6-6 of FIG. 5;

FIG. 7 is a perspective view, partially shown in section, of analternative embodiment of a super elastic wire for use in the materialsdelivery instrument of FIG. 1;

FIG. 8 is a perspective view of the materials delivery instrument ofFIG. 7 initially positioned adjacent the anastomosis formed between apair of tubular tissue sections;

FIG. 9 is a perspective view of the materials delivery instrument ofFIG. 7 initially encircling the anastomosis;

FIG. 10 is a perspective view of the materials delivery instrument ofFIG. 7 completely encircling the anastomosis;

FIG. 11 is a perspective view of the materials delivery instrument ofFIG. 7 partially reoriented parallel to the tubular tissue sections andspraying treatment material onto the anastomosis;

FIG. 12 is a perspective view of an alternative embodiment of amaterials delivery instrument;

FIG. 13 is an enlarged view of the distal end of the materials deliveryinstrument of FIG. 12;

FIG. 14 is a perspective view of the distal end of the materialsdelivery instrument of FIG. 12 initially positioned adjacent ananastomosis formed between a pair of tubular tissue sections andinitially spraying treatment material from the instrument onto theanastomosis;

FIG. 15 is a perspective view of the instrument of the materialsdelivery instrument being advanced around the anastomosis to spraytreatment material onto the anastomosis;

FIG. 16 is a perspective view of the instrument completely encirclingthe anastomosis to spray a complete circle of treatment material ontothe anastomosis;

FIG. 17 is a perspective view of the instrument being retracted backaround the anastomosis to spray a second coat of treatment material ontothe anastomosis; and

FIG. 18 is a perspective view of the instrument, retracted into thecatheter sheath, and being withdrawn from the anastomosis site.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed materials delivery instrumentwill now be described in detail with reference to the drawings whereinlike numerals designate identical or corresponding elements in each ofthe several views. As is common in the art, the term ‘proximal” refersto that part or component closer to the user or operator, i.e. surgeonor physician, while the term “distal” refers to that part or componentfurther away from the user.

Referring to FIG. 1, there is disclosed a materials delivery instrument10 for extraluminal delivery of treatment material to the circumferenceof an anastomosis formed between two tubular tissue sections. Materialsdelivery instrument at 10 generally includes an outer sheath 12 and anelongate tubular member 14 movably mounted within a lumen 16 of outersheath 12. Materials delivery instrument 10 includes a distal end 18which is positionable adjacent the anastomosis in order to deliver thetreatment material to a circumference of the anastomosis as described inmore detail hereinbelow. A source of treatment material 20 is providedfor use with materials delivery instrument 10.

Lumen 16 of outer sheath 12 extends from a proximal end 22 of outersheath 12 to a distal end 24 of outer sheath 12. A handle 26 is formedon proximal end 22 of outer sheath 12 to move outer sheath 12 relativeto elongate tubular member 14. A relatively flexible center portion 28extends distally from handle 26 to facilitate manipulation of materialsdelivery instrument 10 within the body of a patient. A relatively rigiddistal portion 30 of outer sheath 12 extends distally from flexiblecenter portion 28 of outer sheath 12. Rigid distal portion 30 isprovided to restrain a distal portion 32 of elongate tubular member 14when elongate tubular member 14 is in a proximal position relative toouter sheath 12 and to release distal portion 32 of elongate tubularmember 14 when elongate tubular member 14 is moved distally relative toouter sheath 12. A proximal end 34 of elongate tubular member 14 isconfigured to receive source of treatment material 20.

Referring to FIGS. 1 and 2, a plurality of lumens, such as an auxiliaryor first lumen 36, a treatment or second lumen 38 and a shaping or thirdlumen 40 are provided within elongate tubular member 14. First lumen 36extends completely from proximal end 34 of elongate tubular member 14 toa distal end 42 of elongate tubular member 14. First lumen 36 isprovided to accommodate various auxiliary functions such as, forexample, a source of air pressure, optical devices, cautery devices etc.

Second lumen 38 is provided to receive source of treatment fluid 20 at aproximal end 44 thereof. Referring for the moment to FIG.6, second lumen38 includes a plug 46 positioned within a distal end 48 of second lumen38 in order to seal distal end 48.

With continued reference to FIGS. 1 and 2, third lumen 40 extendsproximally from distal end 42 of elongate tubular member 14 and isconfigured to receive a super elastic structure or wire 50 formed from ashape memory alloy. The nature of a shape memory alloy allows the alloyto retain a preformed state or shape when the alloy is in an unstressedor unrestrained condition and allows the alloy to be deformed to anothershape by restraining the alloy in a stressed condition. Super elasticwire 50 may be formed from various shapes of materials such as, forexample, round wire, rectangular wire, sheet alloys, etc. Super elasticwire 50 is provided to configure the shape of distal portion 32 ofelongate tubular member 14 as distal portion 32 is extended beyonddistal end 24 of outer sheath 12.

As the best shown in FIG. 1, and as noted above, super elastic wire 50is positioned within third lumen 40 formed in distal portion 32 ofelongate tubular member 14. As shown, when distal portion 32 of elongatetubular member 14 is retracted within rigid distal portion 30 of outersheath 12, super elastic wire 50 is restrained in a relatively straightshape or stressed condition. It should be noted that, while superelastic wire is disclosed as being positioned within third lumen 40 ofelongate tubular member 14, it is also contemplated that super elasticwire 50 may be embedded directly into the elongate tubular member 14 ora portion thereof.

Referring now to FIG. 2, in the unstressed or unrestrained condition,super elastic wire 50 includes a relatively straight proximal portion 52and an encircling or loop portion 54 extending distally from a distalend 56 of straight proximal portion 52. A distal end 58 of loop portion54 terminates within third lumen 40 at distal end 42 of elongate tubularmember 14. Since super elastic wire 50 is located within distal end 42of elongate tubular member 14, and the tube is formed from a relativelyflexible material, distal end 42 assumes the shape of super elastic wire50 when it is in the stressed and unstressed conditions. Specifically,when super elastic wire 50 is in the preformed and unstressed condition,loop portion 54 of super elastic wire 50 configures distal end 42 ofelongate tubular member 14 into a loop portion 60 while a proximalstraight portion 62 of elongate tubular member 14 conforms to relativelystraight proximal portion 52 of super elastic wire 50. Loop portion 60of elongate tubular member 14, conforming to the shape of loop portion54 of super elastic wire 50, is provided to encircle the anastomosisformed between two tubular tissue sections to facilitate the applicationof a treatment material to the entire circumference of the anastomosis.

Referring now to FIGS. 1 and 3-6, the use of materials deliveryinstrument 10 to apply a treatment material circumferentially to ananastomosis formed between a pair of tubular tissue sections will now bedescribed. Referring initially to FIG. 1, and as described herein above,source of treatment material 20 is provided for use with materialsdelivery instrument 10. Source of treatment material 20 generallyincludes a pressurized canister 64 containing the treatment material. Avalve 66 is provided on canister 64 to control the flow of the treatmentmaterial out of canister 64. A tube 68 extends from valve 66 andterminates in a connector 70 which is configured to engage proximal end44 of second lumen 38 to supply the treatment material through secondlumen 38 to distal end 42 of elongate tubular member 14 for applicationto the anastomosis. Other sources can be used, such as pumped,compressible chambers, or plunger-driven sources to drive material tothe materials delivery instrument.

Elongate tubular member 14 is initially in a retracted position relativeto outer sheath 12 such that super elastic wire 50 and thus distalportion 32 are restrained in a relatively straight configuration withinrigid distal portion 30 of outer sheath 12.

Referring to FIG. 3, distal end 18 of materials delivery instrument 10is initially positioned adjacent an anastomosis A formed between a pairof tubular tissue sections B and C. Thereafter, elongate tubular member14 is advanced distally through outer sheath 12 (FIG. 1) causing distalportion 32 of elongate tubular member 14 to extend distally out of rigiddistal portion 30 of outer sheath 12. As distal portion 32 of elongatetubular member 14 extends out of distal portion 30, super elastic wire50 and distal portion 32 begin to return to the unstressed state orcondition. Thus, distal portion 32 begins to transform to a loop-shapedportion 60 to initially begin encircling anastomosis A.

Referring now to FIG. 5, when distal portion 32 of elongate tubularmember 14 has been completely extended out of rigid distal portion 30 ofouter sheath 12, loop 60 is fully formed about the circumference ofanastomosis A. Distal portion 32 of elongate tubular member 14 is now ina configuration to apply a treatment material TM to the circumference ofthe anastomosis. Valve 66 is opened to allow treatment material TM toflow from canister 64 through tube 68 and second lumen 38. Referring toFIGS. 5 and 6, a plurality of ports 72 are in fluid communication withdistal end 48 of second lumen 38. The loop 60 desirably extends around a360 degree circle, in certain embodiments. However, some embodimentsaccording to the present disclosure include a loop-shaped portion thatis arcuately shaped and extends around less than 360 degrees.

With specific reference to FIG. 6, ports 72 extend through a sidewall 74formed in distal portion 32 of elongate tubular member 14. Ports 72 arein fluid communication within second lumen 38 so as to discharge orspray treatment material TM onto anastomosis A. As noted herein above,second lumen 38 is sealed at distal end 48 by plug 46. Once valve 46 isopened, treatment material TM is released from canister 64 throughsecond lumen 38 and ports 72 and is simultaneously sprayed on to theentire circumference of anastomosis A. Thus, the use of super elasticwire 50 to configure distal portion 32 of elongate tubular member 14into a loop portion 60 enables materials delivery instrument 10 tosimultaneously spray the entire circumference of anastomosis A with thevarious treatment materials TM's described above, such as sealants,adhesives, or medicaments. Once anastomosis A has been covered with thedesired treatment material TM, proximal end 44 (FIG. 1) of elongatetubular member 14 may be drawn proximally within outer sheath 12 toretract distal portion 32 of elongate tubular member 14 back withinrigid distal portion 30 of outer sheath 12 thereby returning superelastic wire 50 to the relatively straight or stressed condition withinrigid distal end 30 of outer sheath 12.

Referring now to FIG. 7, there is disclosed an alternative embodiment ofa super elastic wire 80 for use with materials delivery instrument 10.Super elastic wire 80 is configured to orient proximal straight portion62 of elongate tubular member 14 perpendicularly to loop portion 60 ofelongate tubular member 14 in order to better visualize thecircumference of the anastomosis during the spraying of the treatmentmaterial onto the anastomosis. Super elastic wire 80 generally includesa relatively straight proximal portion 82 and an encircling or loopportion 84 extending distally from distal end 86 of proximal portion 82.Loop portion 84 terminates in a distal end 88 located adjacent distalend 42 of elongate tubular member 14. In this embodiment, asubstantially right angle or 90° bend 90 is formed between distal end 86of straight portion 82 and a proximal end 92 of loop portion 84. In theunstressed condition, this results in the formation of a substantiallyright angle or 90° bend 94 between straight portion 62 elongate tubularmember 14 and loop portion 60 of tubular member 14. Thus, loop portion60 of elongate tubular member 14 is formed within the plane X-Y whilerelatively straight portion 62 of elongate tubular member 14 extendsperpendicular to loop portion 60 along axis Z-Z.

Referring now to FIGS. 1 and 8-11, the use of materials deliveryinstrument 10, incorporating super elastic wire 80, to apply a treatmentmaterial to the circumference of anastomosis A formed between tubulartissue sections B and C will now be described. Referring initially toFIG. 1, materials delivery instrument 10 is in an initial position withelongate tubular member 14 in a proximal most position within outersheath 12 such that rigid distal portion 30 of outer sheath 12 restrainssuper elastic wire 80 in a relatively straight or stressed conditionwithin rigid distal portion 30. As best shown in FIG. 8, distal end 18of materials delivery instrument 10 is positioned adjacent anastomosis Aformed between first and second tubular tissue sections B and C,respectively.

As best shown in FIGS. 9 and 10, distal portion 32 of elongate tubularmember 14 is initially advanced out of distal end 24 of outer sheath 12to initially begin to form loop 60 in distal portion 32 about thecircumference of anastomosis A (FIG. 9). Continued advancement of distalportion 32 fully forms loop 60 about the circumference of anastomosis A(FIG. 10).

Referring now to FIGS. 10 and 11, once loop 60 has been fully formed andcompletely encircles anastomosis A, continued advancement of straightportion 62 of elongate tubular member 14 out of rigid distal portion 30of outer sheath 12 further releases super elastic wire 80 from therestrained condition to the un-restrained condition allowing bend 90 tobe formed between straight portion 82 and loop portion 84 of superelastic wire 80. This causes bend 94 to form in elongate tubular member14 between loop portion 60 of elongate tubular member 14 and straightportion 62 of elongate tubular member 14. Specifically, straight portion62 of elongate tubular member 14 moves in the direction of arrow E froman orientation perpendicular to a longitudinal axis W-W of tubulartissue sections B and C to an orientation wherein the longitudinal axisZ-Z straight portion 62 lies substantially parallel to longitudinal axisW-W of tubular tissue sections B and C. This allows better visualizationof anastomosis A during the application of treatment material TM toanastomosis A.

Referring specifically to FIG. 11, once elongate tubular member 14, andspecifically loop 60, has been properly positioned about anastomosis A,treatment material TM is sprayed simultaneously through all ports 72onto the full circumference of anastomosis A.

Referring now to FIG. 12, there is disclosed an alternative embodimentof a materials delivery instrument 100 which is substantially similar tomaterials delivery instrument 10 described herein above. Materialsdelivery instrument 100 generally includes an outer sheath 102 and aninstrument 104 extending through a lumen 106 of outer sheath 102. Outersheath 102 includes a handle 108 having a flexible center portion 110extending distally from handle 108. A relatively rigid distal portion112 extends distally from flexible center portion 110. Lumen 106 extendsfrom handle 108 to a distal end 114 of rigid distal portion 112.

Instrument 104 is similar to elongate tubular member 14 described hereinabove and includes an auxiliary or first lumen 116, a treatment orsecond lumen 118 and a shaping or third lumen 120. First lumen 116 isopen to a distal end face 122 formed in distal end 124 of instrument 104and extends through instrument 104 to a proximal opening 126 formed inproximal end 128 of instrument 104. First lumen 116 is provided toreceive a source of air pressure such as source of air pressure 130therethrough to assist in spraying treatment material on the tissue.Source of air pressure 130 generally includes a canister of pressurizedair 132 and a valve 134 to control the release of air pressure fromcanister 132. A connector 136 is provided on valve 134 and is configuredto engage proximal opening 138 of first lumen 116.

Second lumen 118 is also open to distal end face 122 and extends throughinstrument 104 to a proximal opening 138. Second lumen 118 is providedto receive a source of treatment material 140 which is substantiallyidentical to source of treatment material 20 described herein above withrespect to materials delivery instrument 10. Source of treatmentmaterial 140 generally includes a pressurized canister 142 containingthe treatment material and a valve 144 provided on canister 142 forcontrolling the flow of treatment material out of canister 142, oranother source, as discussed above. A tube 146 extends from valve 144and terminates in a connector 148 configured to engage proximal opening138 of second lumen 118.

Third lumen 120 is configured to receive a super elastic wiresubstantially identical to super elastic wire 50 described herein abovewith respect to materials delivery instrument 10 and as described inmore detail here and below.

Referring now to FIG. 13, a shield or deflector 150 is provided on endface 122 adjacent first lumen 116. Deflector 150 is provided to direct astream of airflow SA, received through first lumen 116 from source ofair pressure 130, into treatment material TM ejected from second lumen118 to facilitate atomizing and uniformly spraying treatment material TMonto the desired tissue T.

Referring now to FIGS. 12 and 14-18, and initially with respect to FIG.12., the use of materials delivery instrument 100 to spray treatmentmaterial TM onto an anastomosis A formed between a pair of tubulartissue sections B and C will now be described. In the initial position,instrument 104 is in a proximal most position within the outer sheath102. Source of treatment fluid 140 is connected to proximal opening 138of second lumen 118 and source of air pressure 130 is connected toproximal opening 126 of first lumen 116. Referring now to FIG. 14,initially, a distal end 152 of materials delivery instrument 100 ispositioned adjacent anastomosis A. Valve 144 on source of treatmentmaterial 140 (FIG. 12) is opened to force treatment material TM out ofsecond lumen 118 towards anastomosis A. Likewise, valve 134 on source ofair pressure 130 (FIG. 12) is opened to force stream of airflow SAthrough first lumen 116 and out of distal end face 122 of instrument104. As stream of airflow SA exits distal end face 122 it engages, andis directed by, deflector 150 towards treatment material TM to atomizetreatment material TM and provide a uniform pattern of treatmentmaterial TM as it is applied to anastomosis A.

Referring now to FIG. 15, instrument 104 is moved distally relative toouter sheath 102 allowing a distal portion 154 of instrument 104 to movedistally relative to distal end 114 of outer sheath 102. As noted hereinabove, instrument 104 is similar to elongate tubular member 14 describedherein above and includes a super elastic wire 156 positioned withinthird lumen 120 in distal end portion 154 of instrument 104. Superelastic wire 156 is identical to super elastic wire 50 described hereinabove and is provided to shape distal portion 154 into a loopconfiguration in a manner identical to that described herein above withrespect to loop proportion 60 of elongate tubular member 14. As distaland portion 154 of instrument 104 is advanced in the direction of thearrow G, treatment material TM, assisted by stream of airflow SA,continues to be sprayed out of end face 122 in distal end 124 ofelongate tubular member 104 and onto anastomosis A.

As best shown in FIG. 16, continued advancement of distal portion 154 inthe direction of arrow G results in the formation of a line of treatmentmaterial TM about the complete conference of anastomosis A. Thus,materials delivery instrument 100 is configured to progressively spraytreatment material TM about the circumference of anastomosis A as distalportion 154 is advanced around anastomosis A. This allows the surgeon tostop, or reorient the direction of, the sprayed treatment material TMduring the application to anastomosis A to ensure that treatmentmaterial TM is accurately and uniformly sprayed onto the circumferenceof anastomosis A.

Referring now to FIGS. 17 and 18, in order to deliver a more completeand uniform application of treatment material TM to anastomosis A,treatment material TM, assisted by source of airflow SA, may continue tobe sprayed over the previously applied layer of treatment material TMupon retraction of distal portion 154 back around anastomosis A in thedirection of arrow H and into distal end 114 of outer sheath 102.Alternatively, distal portion 154 may be advanced in the direction ofarrow G (FIGS. 15 and 16) about the circumference of anastomosis A priorto the discharge of treatment material TM and initiating and completelyspraying treatment material TM, assisted by source of airflow SA, ontoanastomosis A as distal portion 154 is retracted in the direction ofarrow H.

Thus, materials delivery instrument 100 provides the ability toprogressively spray treatment material TM onto anastomosis A both asdistal portion 154 it is advanced to form a loop about anastomosis A andas distal portion 154 is retracted from around anastomosis A.Alternatively, the spraying of treatment material TM may be stopped andreoriented in either direction to more accurately apply treatmentmaterial TM to anastomosis A. As noted herein above, this allows thesurgeon to ensure that a complete and uniform layer of treatmentmaterial TM is applied to anastomosis A.

In a further embodiment of the present disclosure, the materialsdelivery instrument may be used intra luminally. Ports are disposed onan exterior side of the elongate tubular member so as to discharge thematerial outwardly. The instrument may otherwise be as described inFIGS. 1-6.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, and as noted herein above,the disclosed super elastic wire may either be contained within a lumenof the disclosed instrument or maybe directly embedded within the distalend of the disclosed instrument. Further, the preformed shape of thesuper elastic wire may assume other configurations such as, for example,spiral, oval, etc. Additionally, further additional lumens may beprovided within the disclosed instrument to accommodate various otherfunctions such as, for example, the provision of optical devices,electrocautery devices, etc. Therefore, the above description should notbe construed as limiting, but merely as exemplifications of particularembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended hereto.

1. A materials delivery instrument comprising: an elongate tube having atreatment lumen, the treatment lumen extending from a proximal end ofthe instrument and terminating short of the distal end of theinstrument; at least one port extending between the treatment lumen andan exterior of the distal end of the instrument; and a super elasticwire positioned within a distal end of the instrument, wherein the superelastic wire has a straight configuration in a stressed condition and aloop configuration in the unstressed condition such that the distal endof the instrument assumes the shape of the super elastic member forencircling a tubular tissue section.
 2. The materials deliveryinstrument as recited in claim 1, further comprising an outer sheathmovably positioned over the instrument such that the super elasticmember is in the stressed condition when retracted into the sheath andin the unstressed condition when the super elastic member is extendedbeyond a distal end of the sheath.
 3. The materials delivery instrumentas recited in claim 2, further comprising a source of treatment materialprovided at a proximal end of the treatment lumen for delivery to the atleast one port.
 4. The materials delivery instrument as recited in claim3, wherein the treatment material is an adhesive.
 5. The materialsdelivery instrument as recited in claim 4, wherein the adhesive is afibrin glue.
 6. The materials delivery instrument as recited in claim 3,wherein the treatment material is a sealant.
 7. The materials deliveryinstrument as recited in claim 3, wherein the treatment material is amedicament.
 8. The materials delivery instrument as recited in claim 2,wherein the super elastic wire is embedded in the distal end of theinstrument.
 9. The materials delivery instrument as recited in claim 2,wherein the instrument includes a shaping lumen located within thedistal end of the instrument and the super elastic member is positionedwithin the shaping lumen.
 10. The materials delivery instrument asrecited in claim 1, wherein the super elastic member has a proximalportion oriented perpendicular to a plane defined by the loop when thesuper elastic member is in the unstressed condition.
 11. A materialsdelivery instrument comprising: an elongate tube having a treatmentlumen for receipt of treatment material therethrough, the treatmentlumen extending from a proximal end of the instrument to the distal endof the instrument; an auxiliary lumen for receipt of air pressure andextending from a proximal end of the instrument to the distal end of theinstrument; and a super elastic wire positioned within a distal end ofthe instrument, wherein the super elastic wire has a straightconfiguration in a stressed condition and a loop configuration in theunstressed condition such that the distal end of the instrument assumesthe shape of the super elastic wire for extending around a tubulartissue section.
 12. The materials delivery instrument as recited inclaim 11, further comprising an outer sheath movably positioned over theelongate delivery instrument such that the super elastic wire is in thestressed condition when retracted into the sheath and in the unstressedcondition when the super elastic wire is extended beyond a distal end ofthe sheath.
 13. The materials delivery instrument as recited in claim11, further comprising a deflector positioned adjacent a distal end ofthe auxiliary lumen for directing airflow towards treatment materialejected from a distal end of the treatment lumen.
 14. The materialsdelivery instrument as recited in claim 11, further comprising a shapinglumen formed within a distal end of the instrument such that the superelastic member it is positioned within the shaping lumen.
 15. Thematerials delivery instrument as recited in claim 11, wherein the superelastic wire has a proximal portion oriented perpendicular to a planedefined by the loop when the super elastic wire is in the unstressedcondition.
 16. A method of delivering treatment material to ananastomosis formed between a pair of tubular tissue sections comprising:providing a materials delivery instrument including: an elongate tubehaving a treatment lumen, the treatment lumen extending from a proximalend of the instrument and toward a distal end of the instrument; a portextending between the treatment lumen and an exterior of the distal endof the instrument; a super elastic wire positioned within a distal endof the instrument, the super elastic wire having a straightconfiguration in a stressed condition and a loop configuration in anunstressed condition such that the distal end of the instrument assumesthe shape of the super elastic wire for encircling a tubular tissuesection; and an outer sheath movably positioned over the instrument suchthat the super elastic wire is in the stressed condition when theinstrument is retracted into the sheath and in the unstressed conditionwhen the instrument is extended beyond a distal end of the sheath;positioning a distal end of the materials delivery instrument adjacentan anastomosis formed between a pair of tubular tissue sections;extending the instrument beyond the distal end of the sheath to releasethe super elastic wire from the stressed condition to the unstressedcondition such that the instrument encircles the anastomosis; andspraying treatment material out of the port and onto the anastomosis.17. The method as recited in claim 16, wherein the port extends througha side wall in the instrument and the treatment material is sprayedthrough the port and onto the anastomosis.
 18. The method as recited inclaim 16, wherein the treatment material is sprayed onto the anastomosisas the instrument is extended from the sheath and around theanastomosis.
 19. The method as recited in claim 16, wherein thetreatment material is sprayed onto the anastomosis as the instrument isretracted back into the sheath.
 20. The method as recited in claim 16,further comprising the steps of positioning the distal end of thematerials delivery instrument substantially perpendicular to the tubulartissue sections and reorienting the materials delivery instrumentsubstantially parallel to the tubular tissue sections prior to sprayingthe treatment material onto the anastomosis.